Nasolabial Aesthetics Following Cleft Repair: An Objective Evaluation of Subjective Assessment. (October 2019)

• Record Type: Journal Article
• Authors: Kantar, Rami S.; Maliha, Samantha G.; Alfonso, Allyson R.; Wang, Maxime M.; Ramly, Elie P.; Eisemann, Bradley S.; Shetye, Pradip R.; Grayson, Barry H.; Flores, Roberto L.
• Is Part Of: Cleft palate-craniofacial journal. Volume 56:Number 9(2019)
• Page Start: 1157
• Page End: 1163
• Publication Date: 2019-10
• Subjects: craniofacial morphology -- facial morphology -- lip form -- nasal morphology; Cleft palate -- Periodicals; Skull -- Abnormalities -- Periodicals; Cranial manipulation -- Periodicals; Skull -- Abnormalities -- Surgery -- Periodicals; Face -- Abnormalities -- Surgery -- Periodicals; Fente palatine -- Périodiques; Crâne -- Malformations -- Périodiques; Manipulation crânienne -- Périodiques; Crâne -- Malformations -- Chirurgie -- Périodiques; Face -- Malformations -- Chirurgie -- Périodiques; Cleft palate; Cranial manipulation; Face -- Abnormalities -- Surgery; Skull -- Abnormalities; Skull -- Abnormalities -- Surgery; Cleft Lip; Cleft Palate; Facial Bones -- abnormalities; Skull -- abnormalities; Periodicals; Periodicals; Periodicals; 617.522
• DOI: 10.1177/1055665619851432
• Languages: English
• ISSNs: 1055-6656

Abstract

Objective: Assess the weight and contribution of each of the parameters of the Asher-McDade Scale to overall subjective assessment of nasolabial aesthetics following cleft lip repair. Design: Retrospective cohort evaluation. Setting: Cleft and craniofacial center. Participants: Forty-one patients who underwent unilateral cleft lip repair. Interventions: Unilateral cleft lip repair. Main Outcome Measures: Nasolabial rating using the Asher-McDade scale and overall subjective assessment of nasolabial aesthetics using a rank score following unilateral cleft lip repair. Results: Strong interrater reliability was observed between the 3 raters. Significant association was determined on bivariate analysis between nasal form score (β = 27.06; P < .001), nasal symmetry score (β = 26.41; P < .001), nasal profile score (β = 28.75; P < .001), vermilion border score (β = 13.40; P = .012), and the ranking score. Adjusted β coefficients obtained from multivariate regression analysis were used to develop a modified nasolabial appearance score (over 5), that is, weighted for each of the 4 parameters: nasal form (over 8, adjusted β = 14.33), nasal symmetry (over 5, adjusted β = 7.96), nasal profile (over 5, adjusted β = 9.44), and vermilion (over 2, adjusted β = 3.31). Regression analysis between our modified nasolabial appearance score and patient ranking score demonstrated superior goodness of fit when compared to the Asher-McDade overall nasolabial appearance score ( R 2 = .80; P < .001 vs R 2 = .69; P < .001). Conclusion: The parameters evaluated in the Asher-McDade scale have different weights and contribute differently to overall subjective assessment of nasolabial aesthetic outcomes following cleft lip repair. Adjusting for their weights results in a modified score that demonstrates superior correlation with overall subjective assessment of nasolabial aesthetic outcomes.